Monday, July 29, 2019

Are You Currently Taking Zejula? is working with Tesaro, the makers of Zejula. Survivornet is editorially independent but has been hired by Tesaro to interview women who are currently taking Zejula.

They are not asking women to be positive or negative about the medication or asking them about their experiences with side effects etc.

Survivornet will pay you $1,000 for your time and effort and cover all your expenses to bring you out to NY. You would be videoed and essentially have 2 lines to say: 1) you are currently taking Zejula for either maintenance or recurrence of OC and 2) to contact Tesaro for more information to see if this medication is appropriate for you.

If you are interested, Survivornet would like to do the filming on August 16, 2019 but this could be negotiated. For more information, contact Alex Buxton at 929-304-9400 or via email at

Wednesday, July 24, 2019

A Collaborative Effort has Uncovered Novel Therapies to Treat an Aggressive Form of Ovarian Cancer That is Unresponsive to Standard Treatment

This research came out of the funding from the Department of Defense Ovarian Cancer Research Program. Here's the article that's up on their website:

The Ovarian Cancer Research Program (OCRP) formed the Ovarian Cancer Academy to bring together talented and highly committed Early-Career Investigators (ECIs) along with experienced mentors to help establish the ECIs as successful and highly respected ovarian cancer researchers. To create an opportunity for the ECIs to form meaningful and productive collaborations both within the Academy and in the ovarian cancer research community, the OCRP offered the Ovarian Cancer Academy Collaborative Award in fiscal year 2014 (FY14). The award stipulated that the proposed collaboration be led by an Initiating Principal Investigator (PI) from the Academy and a team consisting of Partnering PIs, which could be other ECIs or independent investigators not affiliated with the Academy.
A team led by Dr. Panagiotis Konstantinopoulos was awarded the FY14 Ovarian Cancer Academy Collaborative Award. The other members of the team include fellow ECI Academy member Dr. Rugang Zhang and Dr. Dipanjan Chowdhury, who was not a member of the Academy.  The project aimed to develop strategies against cyclinE1 (CCNE1) amplified ovarian cancer, the most deadly ovarian cancer due to a lack of responsiveness to standard chemotherapy. Excitingly, the team has had success in identifying and validating heat shock protein 90 (HSP90) as a novel therapeutic target. 
The functional homologous recombination (HR) in CCNE1 amplified cells allows them to repair the DNA damage caused by chemotherapy, making them chemoresistant. HSP90 is a chaperone protein that assists proteins, including CCNE1 and those involved in HR, to fold properly. The team hypothesized that the inhibition of HSP90 would interfere with HR and downregulate CCNE1, and, alone or in combination with other DNA damage inducing drugs, may induce lethality in CCNE1 amplified cells.

The team’s results revealed that HSP90-inhibition downregulates HR DNA repair in CCNE-1 amplified cell lines and induces significant cell death. They determined that an HSP90-inhibitor, AT13387, synergized with DNA damage inducing agents, such as PARP-inhibitors, and enhanced cell death in CCNE1-amplified cell lines. Next, the team assessed the effects of the combination treatment of HSP90-inhibitors and PARP-inhibitors in patient derived CCNE1-amplified ovarian cancer tumors in a mouse model. They determined that the combination treatment inhibited tumor growth and was more effective than either treatment alone, suggesting that HSP90 inhibitors in combination with PARP-inhibitors may be an effective treatment for CCNE1-amplified ovarian cancer.

These impressive results supported by the OCRP have led to the initiation of a Phase 1 clinical trial of the PARP inhibitor, olaparib, and HSP90 inhibitor, AT13387, for the treatment of recurrent ovarian cancer and other metastatic solid tumors. If successful, this trial could validate this novel therapeutic strategy to treat patients with CCNE1-amplified ovarian cancer tumors who have poor outcomes due to the ineffectiveness of standard treatment.

Tuesday, July 23, 2019

Medicaid Expansion Narrows Racial Gaps in Access to Timely Ovarian Cancer Care: Study

This article first appeared on OCRA webpage and summarizes some of the findings of the American Society  of Clinical Oncology's annual meeting in June of 2019.

 The annual Medicaid expansion may have significantly reduced racial disparities in access to earlier ovarian cancer treatment, according to a new study. 
The findings, which were presented at the American Society of Clinical Oncology’s annual meeting, show that blacks were 4.8 percentage points less likely than whites to receive care in a timely manner, defined in the study as within 30 days of diagnosis. 
In states where Medicaid was expanded under the Affordable Care Act (ACA), however, black patients saw a 6.1 percentage point improvement in access to timely care for ovarian cancer. Early detection and treatment of ovarian cancer is crucial, because survival rates for the disease plummet as it progresses. 

“Many studies have described racial disparities that exist in cancer care, but few have shown what kind of interventions improve health equity—we now have evidence that Medicaid expansion can mitigate certain health disparities,” Amy Davidoff, Ph.D., senior research scientist in health policy at Yale University, said in a statement. The researchers did not find a statistically significant increase in access to timely ovarian cancer care across all 30,000 study participants, however. For whites, for example, Medicaid expansion led to a 2.1 percentage point increase in access, which was not significant. 
However, the disparity between access for white and blacks “all but disappeared,” the study found. 

The ACA expanded access to coverage both through Medicaid expansion and subsidies available to low-income people seeking plans on the exchanges—and that’s the key to the changes the study observed, the researchers said. 

There is no screening test especially for early-stage ovarian cancer, but the sooner a woman reports the symptoms, the more quickly she can be treated. And women with insurance are far more likely to make that trip to the doctor earlier, according to the study. 
“We also know that uncertainty about having health insurance, especially for someone newly diagnosed with cancer, can make a big difference in getting appropriate care in a timely manner,” Davidoff said. 

The researchers are now working to build models that can project the variance in treatment outcomes between patients treated in expansion and non-expansion states. 

Tuesday, July 16, 2019


What is a CA125 blood test?

CA125 is a protein that both men and women have in their blood. The normal level of this is 35 units per millilitre (U/mL), or lower.
A CA125 blood test is used to check the level of the protein in the blood. It can be carried out at a local doctor’s surgery if they have the facilities, or the patient will be referred to their local hospital the same way they would for any other blood test. 

When might a CA125 blood test be necessary? 

A CA125 blood test should be requested if a doctor suspects a patient's symptoms could be caused by ovarian cancer. A referral for this blood test should be made if a woman is presenting with any of the four main symptoms of ovarian cancer:
  • Persistent stomach pain
  • Persistent bloating
  • Needing to wee more frequently or urgently
  • Difficulty eating or feeling full more quickly
A referral for a CA125 blood test on presentation of these symptoms is particularly important if they are persistent, frequent and out of the ordinary with no other obvious explanation. A doctor would usually refer for a CA125 blood test following a physical abdominal or internal vaginal examination. 

Does an increased CA125 level mean ovarian cancer?

An elevated CA125 level is not a diagnosis of ovarian cancer. More investigations are required to determine what is causing the elevated CA125 level. Patients will be referred for a pelvic or transvaginal ultrasound scan to gain a better internal picture and to identify any abnormal masses on or around the ovaries.
If abnormal masses are seen a patient would usually then require more scans, and some explorative surgery in order to make a certain diagnosis of ovarian cancer. You can find out more about how ovarian cancer is diagnosed here.

What else can cause a CA125 to be elevated?

There are a number of conditions that can cause a CA125 level to be elevated. They include the following:
  • Pregnancy
  • Endometriosis 
  • Pelvic inflammatory disease
  • Endometriosis 
  • Menstruation 
  • Fibroids
  • Benign ovarian cysts
  • Pancreatitis 
  • Renal failure 
  • Liver cirrhosis 
  • Chest infection 
  • It is also important to note that some women will have naturally high CA125 levels in their blood.

    Can a CA125 blood test be used as a screening tool for ovarian cancer? 

    Currently, it is not possible to use CA125 blood tests as a way of screening women for ovarian cancer for a number of reasons. 
    As previously discussed it is not just ovarian cancer that can cause an elevated CA125 reading, there are many other things that can cause this to be the case, along with the fact that some women will have a naturally elevated level with no cause for concern. So not all women with a raised CA125 level will have ovarian cancer, and it is also important to consider some women may have ovarian cancer but have a normal CA125 reading. 
    Annually screening all women with a CA125 blood test could lead to many being referred for further investigations that are unnecessary, causing needless worry and the possibility of having to undergo inappropriate surgery for no reason.
    In 2015 the results of a long-term study looking at the effectiveness of annual CA125 blood tests and ultrasound scans found that in some instances more women were diagnosed with the disease earlier, and in some of these cases death rates from the disease were reduced. However, further analysis is required to determine if these results can be conclusive and cost-effective enough for CA125 blood tests and ultrasound scans to form part of a national screening programme.

    What other research is happening in screening for ovarian cancer?  

    Ovarian Cancer Action funds the work of Professor Ahmed at the University of Oxford and so far, the team have made several exciting discoveries that have taken them closer to answering that question. They have found that the number of cells that have a protein called SOX2 is markedly increased in the fallopian tubes of women with or at high risk of ovarian cancer. Having a better understanding of how the disease develops is key to developing a screening tool.
    Although they have made some exciting discoveries, there is still a lot more research to be done. Identifying the SOX2 protein is an important step forward but it’s very difficult to get to, meaning a screening tool centred around it would be quite invasive. They are now looking for other changes that take place in the body simultaneously to the SOX2 protein production and, by harnessing different markers, they hope to find another marker that is easier to test for. 
    They hope to complete their next stage of investigations within the next five years and then the next step would be to translate their findings into clinical research. 
    This article was published by Ovarian Cancer Action.

Thursday, July 11, 2019

Donna Wiegle's TEAL on WHEELS: Ovarian Cancer Awareness Tour

Do you know the signs and symptoms of ovarian cancer?  I didn't think so.
My name is Donna Wiegle and I am living with advanced stage cancer. Three years ago, I was diagnosed with stage IIIB ovarian cancer and given a 5-year prognosis. It took my medical team more than two years to figure out what was wrong with me.
Over the past three years, I have heard many stories that were like mine. I have met women who knew something was wrong with them and they felt like no one was listening. They received diagnoses of irritable bowel syndrome, GERD, urinary tract infection, diverticulitis, chronic fatigue, and even suggestions of mental health issues—no one suspected ovarian cancer.

In her lifetime, a woman’s chance of getting breast cancer is 1 in 8.  Her chance of getting ovarian cancer is 1 in 78.  With no screening tests for ovarian cancer, by the time most women are diagnosed, they have stage III or IV cancer with  5-year survival rates of less than 39% and 17%. Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system.  

Breast cancer’s color PINK is everywhere helping to raise awareness about the disease.  Ovarian cancer’s color is TEAL, which is virtually nowhere to be found.  If I asked the next ten women I meet what the symptoms of ovarian cancer are, I would be surprised if any could tell me.  I would also be surprised if the next ten people working in the medical field could tell me the symptoms of ovarian cancer.  This MUST change!

TEAL on WHEELS will encompass my mission of spreading ovarian cancer awareness across the United States. I plan to make this ride solo—just me, my bike, and my message.
I found the perfect bike...a teal and white 2016 Harley Davidson Heritage Classic motorcycle that I will ride across the country.   A leather jacket with a TEAL on WHEELS logo on the back and a flag with a teal cancer ribbon proudly displayed on the back of the bike will draw attention to me and the bike.  This will allow me to share my message at gas stations, hotel parking lots, restaurants, highway toll booths—everywhere I go. 
I plan to schedule stops along with way to talk with women’s groups, to doctors and nurses at medical centers—I might even show up at churches on Sunday mornings to spread my message.

I will be carrying business cards with the symptoms of ovarian cancer—abdominal bloating, lower back pain, frequent and urgent need to urinate, fatigue—symptoms that are easily dismissed by women and their doctors.  Unlike other cancers, there are no screening tests for ovarian cancer, only symptoms.

September is Ovarian Cancer Awareness month and that is when I will be riding across the country sharing my message.  TEAL on WHEELS will be a month-long ride.

In addition to raising awareness, I want to raise money to be donated to two non-profit cancer organizations.  The first, Ovarian Cancer Research Fund Alliance (OCRFA) is the largest ovarian cancer research organization in the world.  OCRFA works to advance research to prevent, treat and defeat ovarian cancer.  

The second non-profit organization, Turning the Tide Ovarian Cancer Retreats, Inc. has a different mission. Since 2012, Turning the Tide has hosted ovarian cancer patients and survivors living in the Northeast, for a 5-day retreat at Camp Kieve in Nobleboro, Maine. Turning the Tide Ovarian Cancer Retreats offers women the opportunity to come together and bond creating a Teal Sisterhood at a beautiful lakefront setting.  

All the donations received through this GoFundME campaign for the TEAL on WHEELS Ovarian Cancer Awareness Tour will be handled by the Beth C. Wright Cancer Resource Center, a non-profit organization in Ellsworth, Maine.  Michael Reisman is the Executive Director of the Beth C. Wright Center and will be managing all of the donations for TEAL on WHEELS.

I intend to make this ride as a solo journey, but I can’t do it alone—I need your support. 
Won’t you help me by donating to TEAL on WHEELS?

Tuesday, July 9, 2019

Novel Treatment Turns Tumors into "Cancer Vaccine Factories"

I found this article online at
By Mark L. Fuerst
In-situ vaccine may enhance immunotherapy response in resistant cancers, study shows.
A novel approach to cancer immunotherapy injects immune stimulants directly into a tumor to “teach,” induce the immune system to destroy the cancer and other tumor cells throughout the body. The three-step approach works as an in-situ cancer vaccine, researchers said.
A preliminary study could point to a new way of making immunotherapy more effective in cancers that have proven to be resistant to treatment and also enhance the effects of checkpoint blockade.
“The in-situ vaccine approach has broad implications for multiple types of cancer,” the study’s lead author, Joshua Brody, MD, of the Icahn School of Medicine at Mount Sinai in New York City, told the Reading Room. “This method could also increase the success of other immunotherapies, such as checkpoint blockade. The in-situ vaccine has multiple benefits: it’s simple, more practicable, costs a fraction of a personalized vaccine [does], and lets us optimize therapy.”
So far, Brody and colleagues have treated 11 patients, median age of 54, with indolent non-Hodgkin lymphoma (NHL), a cancer that, in general, does not respond to immunotherapy. Of the 11 patients who received the experimental therapeutic vaccine, one had a complete remission, two had partial remissions, and six had stable disease.
“This adds a new way to make anti-programmed death-1 (PD-1) agents effective in tumors where they are generally not effective,” Brody said. “PD-1 blockers help 20% of NHL patients, but that leaves the other 80% without effective immunotherapy. This is a novel solution to fix that problem. We have seen dramatic results in the laboratory to make PD-1 blockers more effective, and the vaccine induces systemic clinical remissions that can last for months.”
As immunotherapy continues to benefit from novel approaches to cut immune brake pedals, such as anti‐PD-1 and anti‐cytotoxic T-lymphocyte antigen 4 antibodies, there will be an increasing need to develop immune “steering wheels,” such as vaccines to guide the immune system specifically toward tumor-associated antigens, he noted. One hurdle in cancer vaccines has been the identification of universal antigens to be used in “off‐the‐shelf” vaccines for common cancers. Another hurdle is production of individualized whole tumor cell vaccines.
The new vaccine essentially turns the tumor into cancer vaccine factories by teaching the immune cells to recognize the cancer cells, said Brody. Once identified, the immune cells actively seek out all the cancer cells of the body and kill them. The three-step approach consists of (1) recruiting dendritic cells, (2) loading dendritic cell tumor antigens, and (3) activating the antigen-loaded dendritic cells.
The treatment consists of administering a series of immune stimulants directly into one tumor site. In the first step, a human protein form of FMS-like tyrosine kinase-3 ligand (FLT3L) recruits dendritic cells, which are important immune cells that act like generals of the immune army, Brody explained.
In the second step, low-dose radiation therapy activates the dendritic cells, which then instruct T cells, the immune system’s soldiers, to kill cancer cells and spare non-cancer cells.
In the third step, a toll-like receptor-3 agonist activates the dendritic cells and stimulates the immune army to recognize features of the tumor cells so it can seek them out and destroy them throughout the body.
In laboratory tests in mice, the vaccine drastically increased the success of checkpoint blockade immunotherapy. PD-1 blockade didn’t cure any large tumors, but after adding the vaccine, the cure rate increased to 75%. Side effects were grade 1 or 2 flu-like symptoms and muscle aches that last for a day. “We did not see any autoimmune adverse events,” said Brody.
Clinical Trial Ongoing
A clinical trial for lymphoma, breast, and head and neck cancer patients opened in March 2019 to test the vaccine with checkpoint blockade. The in-situ vaccine is also being tested in the laboratory in liver and ovarian cancers.
“Literally hundreds of immunotherapy trials are accruing thousands of patients each year to understand how to better whip T cells into shape and to get immune soldiers to do their job harder,” said Brody. “Clinical oncologists are frustrated that the majority of patients don’t respond to PD-1 blockers. We may be able to potentiate PD-1 blockade with this in-situ vaccine.”
In a 2018 review of in-situ vaccination, Mee Rie Sheen, PhD, of Harvard Medical School in Boston, and Steven Fiering, PhD, of the Geisel School of Medicine at Dartmouth in Hanover, New Hampshire, noted that local administration of immunostimulatory reagents into a recognized tumor by in-situ vaccination can generate systemic antitumor immunity to fight metastatic disease. “Conventional vaccines contain antigens and immune adjuvants. With in-situ vaccination, the tumor itself supplies the antigen, and the treatment only applies immune adjuvant directly to the tumor,” the authors stated.
They explained that current immunotherapy often fails to eliminate cancer because of local immunosuppression mediated by tumors. In-situ vaccination, in effect, “changes the tumor microenvironment from immunosuppressive to immunostimulatory, stimulates presentation of tumor antigens by antigen‐presenting cells to T cells, and generates systemic antitumor immunity that promotes antigen‐specific effector T‐cell attack of both treated and importantly, untreated metastatic tumors.”
Sheen and Fiering concurred with Brody about the advantages of in-situ vaccination — i.e., that it:
  • Is simple and cost‐effective
  • Has minimal systemic side effects
  • Is a feasible and flexible adjuvant delivery system
  • Exploits all tumor antigens in the tumor to avoid the need to identify antigens
  • Utilizes all antigens in the tumor to minimize immune escape
  • Has potential synergy when combined with other therapies
This article was published by MedPage Today.

Tuesday, July 2, 2019

Trial Examines Tolerance of Maintenance Olaparib in Advanced Ovarian Cancer

This article first appeared in the online journal and was written by Dave Levitan.

An analysis of the phase III SOLO1 trial found no new safety signals when the PARP inhibitor olaparib was given as maintenance therapy for women with newly diagnosed advanced ovarian cancer and a BRCA mutation. Nausea, fatigue, and several other toxicities, including anemia, usually occur early in the course of treatment, suggesting better monitoring is needed in that early period. 

“The tolerability profile of maintenance therapy with the PARP inhibitor olaparib in platinum-sensitive relapsed ovarian cancer is well characterized,” wrote study authors led by Nicoletta Colombo, MD, of the University of Milan-Bicocca in Italy, in a poster presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting (abstract 5539). 

SOLO1 was the first trial evaluating the agent’s use in women with newly diagnosed advanced ovarian cancer. Previously, it showed that maintenance olaparib provides a substantial progression-free survival benefit compared with placebo, and the new analysis examined the safety profile in this new setting. 

The analysis included a total of 260 patients treated with olaparib and 130 treated with placebo, with a median follow-up duration of approximately 41 months. The median duration of treatment was 25 months with olaparib and 14 months with placebo. 

The most common adverse events of any grade included nausea (77% of olaparib patients vs 38% of placebo patients), fatigue/asthenia (63% vs 42%), vomiting (40% vs 15%), anemia (39% vs 10%), and others. Most adverse events were grade 1/2, though grade 3 anemia occurred in 22% of patients receiving olaparib and only 2% of those receiving placebo. 

The median time to first onset of those most commonly reported adverse events was under 3 months for all. The median duration of the first adverse event was also under 3 months for all; it was 1.87 months in the olaparib group for anemia, compared with 1.64 months with placebo. 

Nausea, fatigue/asthenia, anemia, thrombocytopenia, and several other common adverse events were generally managed with supportive therapy, dose interruption, and/or dose reduction. Twenty-three percent of olaparib patients required at least one blood transfusion, compared with 2% of placebo patients. 

Three patients developed acute myeloid leukemia (AML) during the trial in the olaparib group (1.2%). There were no cases of AML or myelodysplastic syndrome in the placebo group. The time to onset of AML in those 3 patients was 173 days, 49 days, and 52 days after stopping olaparib; AML was fatal in all 3 cases. 

“The tolerability profile of olaparib in patients with newly diagnosed ovarian cancer was consistent with that reported in the relapsed-disease setting, with no new safety signals identified,” the authors concluded. “Given that anemia predominantly occurred early, stricter monitoring is required at the beginning of treatment.”